Title: Limberg Flap Repair: Our Experience

Authors: Dr Atul Sharma, Dr Navneet Parashar, Dr Rakesh Sharma, Dr Santosh Sharma

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.75

Abstract

Background: There are numbers of surgical methods have been devised over a year for treatment of pilonidal sinus but none have been accepted as procedure of choice. Plastic reconstruction procedures have advantage of early recovery, less pain, early return to work & low recurrence. Limberg repair is our procedure of choice which we present here as our experience.

Method: From August 2013 to Jan 2017, 57 patients were treated with Limberg flap repair under regional anaesthesia in a Govt. Medical College Kota & associated hospitals.

Results: No major anaesthetic complication or wound infection developed.

One patient (2 percent) had a seroma (with negative culture) and two patients (3.7 percent) had flap necrosis. Patients returned to full activity on the 10th to 15th postoperative day. Patients were followed from 6 to 42 months. There was not a single case of recurrence had been reported.

Conclusion: Excision & Limberg flap repair is an easy and effective technique with short learning curve. Patient comfort, early healing, early return to activity, and least complications and recurrence rates are the advantages of this procedure.

Keywords: Pilonidal sinus; Limberg flap; Rhomboid excision.

References

  1. Humphries AE, James E (2010) Evalua-tion and management of pilonidal disease. Surg Clin North Am 90(1):113–124
  2. Sondenaa K, Andersen E (1995) Patient characteristics and symptoms of in chronic pilonidal sinus disease. Int J Colorectal Dis 10(1):39–42
  3. Hull TL, Wu J (2002) Pilonidal disease. Surg Clin North Am 82:1169–1185
  4. Clothier PR, Haywood IR (1984) The natural history of the post anal pilonidal sinus. Ann R College Surg England 66(3):201–203.
  5. Bascom J (1980) Pilonidal disease: origin from follicles of hairs and results of follicle removal as treatment. Surgery 87:567–572
  6. Casetecker J, Mann BD, Castellanes AF, Strauss J (2006) Pilonidal disease. http://emedicine.medscape.com/article192668. Accessed 11 Dec 2011
  7. Azab AS, Kamal MS, Saad RA, Abount AL, Atta KA, Ali NA (1984) Radical cure of pilonidal sinus by a transposition rhomboid flap. BJS 71(2):154–155
  8. Akca T, Colak T (2005) Primary closure with Limberg flap in treatment of pilonidal sinus-randomized clinical trial. BJS 5074:1081–1084
  9. Akin M, Gokbayir H, Kilic K, Topgul K, Ozdemir E, Ferahkose Z. Rhomboid excision and Limberg flap for managing pilonidal sinus: long-term results in 411 patients. Colorectal Dis 2008;10:945–8.
  10. Urhan MK, Kucukel F, Topgul K, Ozer I, Sari S. Rhomboid excision and Limberg flap for managing pilonidal sinus: results of 102 cases. Dis Colon Rectum 2002;45:656–9.
  11. Katsoulis IE, Hibberts F, Carapeti EA (2006) Outcome of treatment of primary and recurrent pilonidal sinus with Limberg flap. Surgeon 4(1):7–10, 62
  12. Aslam M, Choudhry A (2009) Use of Limberg flap for pilonidal sinus—a viable option. J Ayub Med Coll Abbottabad 21(4)
  13. Urhan MK, Kuckel F, Topgul K, Ozer I, Sari S (2002) Rhomboid excision and Limber flap for managing pilonidal sinus: results of 102 cases. Dis Colon Rectum 45:656–659
  14. Mentes BB, Leventoglu S, Cihan A, Tatlicioglu E, Akin M, Oguz M (2004) Modified Limberg transposition flap for Sacrococcygeal pilonidal sinus. Surg Today 34(5):419–423.

Corresponding Author

Dr Navneet Parashar

Assistant Professor (Surgery) Govt. Medical College, Kota

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.